If you can't beat'em join'em - Why I became a doctor
'I decided people deserve better than what I had gone through. So I looked up how to get into medical school.'
I didn’t have what you would call a “normal” childhood – in a good way! – but I definitely had normal health. The odd cold, the rare episode of vomiting. I probably took more time off school faking being sick than actually being sick! My periods started in year 8, at the age of 13. Again, everything was normal. Little to no pain, regular pads changed every few hours, no PMS or symptoms other than mild cramping. But that didn’t last nearly long enough.
When I was about 14-15 my periods changed. Suddenly they were exceptionally painful, and I had pelvic pain more often than not throughout my cycle. I took so much Nurofen over my high school years I’m surprised I still have kidneys! My bleeding increased too. I couldn’t use just pads anymore. It was heavy tampons AND heavy pads changed between every class. My friends didn’t suffer as much as I did so I knew something was wrong. Thankfully my mum is a human biology teacher. I had a pretty good understanding of the human body, so I researched what could be the cause of my concerns. It was then I stumbled across endometriosis. When I brought my research to her, she agreed. So, like everyone else with medical issues, I went to my GP.
Unfortunately I didn’t get the help I wanted. I got told “endometriosis can’t cause pain outside of your periods”. I was sent for an ultrasound to investigate for ovarian cysts. Of course, like most ladies with endometriosis, a basic pelvic ultrasound showed nothing. Going back to my GP afterwards I was told I was just having normal periods, I had to deal with it, and it would get better after I had children. Keep in mind I was 15 at the time, 2 years before I even met my first boyfriend!
About 6 months later my mum and I decided things were getting ridiculous. I was getting worse, not better. Thankfully my cycles were 6 weeks long so I didn’t have too many periods to battle with and I never missed any school, but I was still suffering more than a teenage girl should. At this point I also had a healthy case of depression to fight and I was getting sick of it. We went to a women’s health GP in Northbridge. I vaguely remember the name Genevieve, an outfit of bright pink, and validation. She told me I sounded like a textbook case of endometriosis and put me on the pill. She also discovered I’d used up almost all my iron stores!
I stayed on the pill for a year before deciding it “wasn’t working anymore”. I soon went back on, it turned out the underlying condition had just gotten worse! I met my now husband at 17 at university and he knew about my condition from day one, he kept me sane through it all. At 21, with the prospect of coming off my family health insurance, I finally got my laparoscopy.
My first appointment with the gynaecologist wasn’t as comforting as I’d hoped. Being stubborn and tough I went in alone and never complained when the male gynaecologist discussed at length with his male student about the symptoms of the endometriosis and the prospect of infertility. Still battling depression, I sat in silence holding back tears. The day of surgery wasn’t much better. I don’t remember seeing him before the operation, and afterwards he came and told me there wasn’t enough endometriosis there to cause my pain, that he had burned away what he saw, showed me a little spot that he had taken a picture of, and said that I was “cured”. I was supposed to go back to see him for pain management but I never wanted to see him again in my life. Seven years on I still haven’t seen an operation report. But thankfully, the pain was improved. I managed my milder symptoms, with over the counter pain relief, and contraceptive pills that gave me a long list of side effects including migraines and mood swings.
During recovery from my surgery I decided people deserve better than what I had gone through. So I looked up how to get into medical school. I finished my undergraduate degree in science, worked for a year, started a second undergraduate degree in arts to improve my grades, and after my final exams for first year Italian I got the news that I wouldn’t need to finish my arts degree. I had a place in medical school in Queensland!
Medical school was “fun”. I got married in first year, while my husband was training for his job interstate. I got pregnant in second year, much to my relief. After having my first daughter I had my rotation studying obstetrics and gynaecology. In clinic I got to take a look at some post-operative photos of a lovely lady who had pelvic pain. I thought “that looks just like what my gynae showed me”. My mentor then told me she had stage 2 endometriosis, a chronic and incurable disease with a high recurrence rate. When I got back to my car that afternoon I cried. I’d spent 5 years thinking I was free of this disease, and now I learned that I couldn’t just go off hormonal therapy and be normal. I also worried about giving my child the siblings I so desperately wanted for her. My husband was working overseas for 6 months at that point in time, leaving me home alone, interstate, with a baby. Even with 3 months of my mum helping out, I was pretty stressed! A year after that I crossed the graduation stage to receive my MD. With a baby bump. And a contract signed to come back home to Perth. My daughter now has a little sister. And they have a mum who is a doctor.
My understanding of endometriosis, how it affects people, who to turn to, and my sanity have all improved by having an amazing support group to turn to. I joined EPSS in my final year of medical school. I’m ashamed to say that I didn’t believe a lot of ladies in the group at first. The teaching I received about endometriosis from my university was superficial, and what I learned from other doctors was often just wrong. Inspired by the group I did my own reading, attended a conference, and broadened my understanding of this disease. More importantly, the group gave me an outlet to discuss my struggles when no one else could understand. Perhaps the most amazing thing I got from the group was inspiration; I haven't seen a single person who has given up, everyone makes the most they can of every day.
After my second child my symptoms have all come back. I have more unrelated issues gained over the years to fight with too. I’ve found myself a great GP and a new gynaecologist. We have plans for a repeat, better laparoscopy with excision of my endometriosis rather than “burning” as soon as I am done with my internship. Next year I’m hoping to get 6 months of obstetrics and gynaecology experience at my current hospital; one day I hope to be the person doing the cutting, removing this awful disease from my “sisters” in Perth. Watch this space! - Dr Katya Fleming November 24, 2017